Longitudinal assessment of neuroanatomical and cognitive differences in young children with type 1 diabetes: Association with hyperglycemia

Nelly Mauras, Paul Mazaika, Bruce Buckingham, Stuart Weinzimer, Neil H. White, Eva Tsalikian, Tamara Hershey, Allison Cato, Peiyao Cheng, Craig Kollman, Roy W. Beck, Katrina Ruedy, Tandy Aye, Larry Fox, Ana Maria Arbelaez, Darrell Wilson, Michael Tansey, William Tamborlane, Daniel Peng, Matthew MarzelliKaren K. Winer, Allan L. Reiss

Research output: Contribution to journalArticlepeer-review

78 Scopus citations

Abstract

Significant regional differences in gray and white matter volume and subtle cognitive differences between young diabetic and nondiabetic children have been observed. Here, we assessed whether these differences change over time and the relation with dysglycemia. Children ages 4 to <10 years with (n = 144) and without (n = 72) type 1 diabetes (T1D) had high-resolution structural MRI and comprehensive neurocognitive tests at baseline and 18 months and continuous glucose monitoring and HbA1c performed quarterly for 18 months. There were no differences in cognitive and executive function scores between groups at 18 months. However, children with diabetes had slower total gray and white matter growth than control subjects. Gray matter regions (left precuneus, right temporal, frontal, and parietal lobes and right medial-frontal cortex) showed lesser growth in diabetes, as did white matter areas (splenium of the corpus callosum, bilateral superior-parietal lobe, bilateral anterior forceps, and inferior-frontal fasciculus). These changes were associated with higher cumulative hyperglycemia and glucose variability but not with hypoglycemia. Young children with T1D have significant differences in total and regional gray and white matter growth in brain regions involved in complex sensorimotor processing and cognition compared with age-matched control subjects over 18 months, suggesting that chronic hyperglycemia may be detrimental to the developing brain.

Original languageEnglish
Pages (from-to)1770-1779
Number of pages10
JournalDiabetes
Volume64
Issue number5
DOIs
StatePublished - May 2015

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